Introduction
Skin hyperpigmentation, also called age spots, typically appears among middle-aged adults, especially those exposed to sunlight frequently. It is associated with age, and older adults usually have many age spots on their skin. Even though this problem is aesthetic and the appearance of hyperpigmentation does not endanger the person’s health status, many individuals want to reduce the visibility of these sports. Hydroquinone is one of the most widespread medications used in clinical practice, leading to the reversal of age sports. Even though hydroquinone is connected with controversy due to its harmful effect on human health, it is typically used to reduce the signs of hyperpigmentation associated with age.
Discussion
Background Information
Age spots are typical for older adults, which makes patients worry about their health and ask professionals for help. Hyperpigmentation is frequently why people in the 40–45 age category seek consultation for skin issues (Charoo, 2022). Even though hyperpigmentation is normal for their age and is not connected with health risks, it causes emotional problems. The intrinsic factors leading to the appearance of hyperpigmentation include genetics, time, and hormones, while the extrinsic characteristics feature pollution, UV radiation, and cigarette smoking (Kang et al., 2021). The intensity of age spots is influenced by physiological characteristics, such as skin phototype, which includes skin color and capacity to tan, sunlight/UV exposure intensity, and duration (Kang et al., 2021). Hyperpigmentation becomes more visible with age due to the accumulative effect of exposure to the factors mentioned above (Kang et al., 2021). It states that the appearance of age spots on the skin is a natural process caused by multiple factors.
Mechanism of Action
Age spots are dermatological issues that people want to reduce for a more aesthetic appearance. Hydroquinone’s mechanism of action leads to the reversal of age spots, which makes this ingredient effective in the therapy (Charoo, 2022). In clinical settings, hydroquinone is widely used as a depigmenting agent to reduce hyperpigmentation (Charoo, 2022). It is possible to describe the mechanism of action as skin bleaching due to the direct influence on the upper layers of the skin hydroquinone has.
The mechanism of action is based on the chemical reaction hydroquinone has on human skin. The experiment by Draelos et al. (2020) analyzes the effect of hydroquinone, also referred to as 2-[2-(2,4-Difluorophenyl)-2-propen-1-yl] from the family of gem difluoro compounds that contributes to skin lightening (Draelos et al., 2020). Hydroquinone also acts as a tyrosinase inhibitor, including 1,3-propanediol (Draelos et al., 2020).
While hydroquinone is not harmful to melanocytes, this chemical can cause skin bleaching (Draelos et al., 2020). The investigation results show that after eight weeks of therapy, TFC-1067 and 2% hydroquinone were the only ones used to reduce age spots, but only hydroquinone lightened them effectively (Draelos et al., 2020). In week 12, this tendency persisted (Draelos et al., 2020). Both products dramatically lightened dyschromic skin, although hydroquinone also lightened normal skin, which was not preferable in some cases (Draelos et al., 2020). This data shows that hydroquinone significantly affects the results of age spot treatment.
The form of hydroquinone is also critical for understanding its mechanism of action. Hydroquinone cream is the most common skin-lightening or depigmenting medication, and its mechanism of action is typical for this ingredient (Schwartz et al., 2022). Applying the cream to the skin makes the interaction direct. In medicine, it is used to manage solar lentigines and dyschromic lesions, including freckles, chloasma, melasma, and post-inflammatory hyperpigmentation (Schwartz et al., 2022). Hydroquinone functions as a skin-lightening agent by preventing the creation of melanin (Schwartz et al., 2022). Due to its molecular resemblance to an analog of melanin precursors, it prevents tyrosinase from converting L-3,4- dihydroxyphenylalanine (L-DOPA) into melanin (Schwartz et al., 2022). In other words, hydroquinone does not allow human skin to create melatonin when it is exposed to sunlight.
The following steps constitute the pathway of melanin synthesis that is the basis of hydroquinone’s mechanism of work. First, L-phenylalanine is hydroxylated to produce L-tyrosine (Schwartz et al., 2022). Then, L-tyrosine is converted by the enzyme tyrosinase to 3,4-dihydroxyphenylalanine (L-DOPA), which is then metabolized to dopaquinone (Schwartz et al., 2022). In the end, skin color changes: black skin becomes brown, while yellow skin becomes red due to the generation of eumelanin and pheomelanin (Schwartz et al., 2022). The description allows assuming that hydroquinone is the depigmentation agent with proven efficiency.
Hydroquinone is typically used with several other components to achieve the best results in reducing visual signs of skin sports. For instance, creams and gels with hydroquinone also feature corticosteroids and retinoids for optimal outcomes (Schwartz et al., 2022). The most popular combination of these ingredients that dermatologists prescribe contains 0.05% fluocinolone acetonide, 0.05% tretinoin, and 4% hydroquinone (Schwartz et al., 2022). This medication is regarded as the typical solution for reducing age spots, but still, the patient requires professional assistance in managing this treatment to avoid potential risks.
Risks
Even though hydroquinone effectively reduces age spots, it is associated with significant health risks. For instance, long-term usage of hydroquinone has been linked to exogenous ochronosis and an increased risk of cancer (Charoo, 2022). For this reason, the government decided to remove cosmetic products containing this ingredient from the market to avoid health risks for the population (Charoo, 2022). There are alternative ways of treating age stops that are not associated with adverse health outcomes, including glutathione and Polupodium leucotomos (Charoo, 2022). The clinical practice shows that these ingredients can be used simultaneously, and the combination allows doctors to achieve their goals in treating age-induced hyperpigmentation (Charoo, 2022). This information shows that the use of hydroquinone is controversial, and there are various opinions among dermatologists concerning its safety.
Conclusion
Hydroquinone effectively reduces the number of age spots and their visibility. It is typically used with other ingredients used for skin lightening, including fluocinolone acetonide and tretinoin. The medication is usually applied as a cream or a gel that works on the skin level. Research shows that age sports are associated with prolonged exposure to sunlight, and they appear over time, which makes them not dangerous for human health. People sometimes want to reduce their visibility because of their aesthetic desires. In general, the mechanism of action of hydroquinone is not harmful to the individual’s health.
At the same time, there is an ongoing dispute concerning its adverse effects on the increased risk of cancer and exogenous ochronosis. Even though hydroquinone does not influence the work of inner organs, the patient’s skin becomes susceptible to sunlight, increasing the risk of cancer development. Healthcare professionals propose that patients use alternative combinations to treat age spots that have proven safe among these medications, such as glutathione and Polypodium leucotomos, which also have proven effects in reducing the visibility of hyperpigmentation and age spots.
References
Charoo, N. A. (2022). Hyperpigmentation: Looking beyond hydroquinone. Journal of Cosmetic Dermatology, 21(10), 4133–4145. Web.
Draelos, Z. D., Deliencourt-Godefroy, G., & Lopes, L. (2020). An effective hydroquinone alternative for topical skin lightening. Journal of Cosmetic Dermatology, 19(12), 3258–3261. Web.
Kang, H. Y., Lee, J. W., Papaccio, F., Bellei, B., & Picardo, M. (2021). Alterations of the pigmentation system in the aging process. Pigment Cell & Melanoma Research, 34(4), 800–813. Web.
Schwartz, C., Jan, A., & Zito, P. M. (2022). Hydroquinone. In StatPearls. StatPearls Publishing. Web.